Organization of the Thoracic Viscera I & II Flashcards

1
Q

thoracic skeleton:

___ & ___ form an ___

all ribs slope ___ from their vertebral attachment

A

rib cage, thoracic vertebral column, irregularly shaped cone

downward

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2
Q

superior thoracic aperture (thoracic outlet):

definition

3 boundaries

A

passageway for trachea, esophagus, many vessels & nerves

(1) first thoracic vertebra
(2) first pair of ribs & costal cartilages
(3) superior margin of manubrium sterni

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3
Q

inferior thoracic aperture:

boundaries (3)

closed by the ___ separating the ___

A

(1) 12th thoracic vertebrae
(2) costal margin
(3) xiphosternal joint

diaphragm, thoracic & abdominal viscera

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4
Q

thoracic cavity:

consists of ___

bounded by___

suprapleural membrane

A

two pleural cavities enclosing the lungs & the mediastinum

the thoracic wall, the diaphragm, & the suprapleural membrane

thickening of endothoracic fascia above the superior thoracic aperture which limits bulging of the lungs into the neck

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5
Q

pleurae:

___ membranes that cover the ___

line the ___

composed of ___ that produces ___

connective tissue is strong enough to support ___

A

thin serous, surface of the lungs

walls, roof, & floor of the pleural cavities

mesothelium (simple squamous epithelium), serous fluid & connective tissue

blood vessels, nerves, & lymphatic vessels

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6
Q

visceral pleura

A

covers the lungs

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7
Q

parietal pleura

A

lines the walls, roof, & floor of the pleural cavities

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8
Q

parietal & visceral pleura are ___ with each other around the ___ (___)

A

continuous

root of the lung (structures entering & leaving the lung & attaching the lungs to the mediastinum)

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9
Q

divisions of parietal pleura:

costal pleura

cervical pleura (cupola)

diaphragmatic pleura

mediastinal pleura

A

lines thoracic wall

extends through thoracic inlet into neck

covers diaphragm

covers the mediastinal surface of each pleural sac

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10
Q

pulmonary ligament:

___ pleura is reflected at the ___ to become continuous w/ the ___

at this point, it ___

___ layer of ___

A

mediastinal parietal pleura, the root of the lung, visceral pleura covering the lung

sags below the hilus as a shirt cuff might hang below a person’s wrist forming a potential space

double, pleura

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11
Q

lines of pleural reflection

A

sharp lines of reflection where costal pleura become continuous w/ the mediastinal & diaphragmatic pleura & limit the pleural cavities

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12
Q

pleural sacs:

far apart in the ___

converge as they’re traced ___ toward the ___ where they contact each other

A

region of the cupola

downward, sternal angle

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13
Q

right pleura:

continuous ___

swings ___

A

straight downward close to the midline

outward & downward along the 7th costal cartilage

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14
Q

left pleura:

anterior reflection deviates ___ at about the level of the ___

it’s usually lateral to the ___ at the level of the ___

it swings ___ along the ___

deviation of left pleura: ___

A

laterally, 4th rib

sternum, 5th & 6th intercostal spaces

outward & downward, 7th costal cartilage

cardiac notch

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15
Q

lower borders of pleural reflections (right & left):

crosses 8th rib at the ___

crosses 10th rib at the ___

crosses 12th rib ___

A

mid-clavicular line

mid-axillary line

adjacent to vertebral border

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16
Q

comparable surface markings for the lungs:

crosses 6th rib at the ___

crosses 8th rib at the ___

crosses 10th rib ___

A

mid-clavicular line

mix-axillary line

adjacent to vertebral border

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17
Q

pleural recesses:

in life, lungs don’t ___

therefore, the surface markings of the lungs & the ___ pleura ___

here, portions of the ___ pleura are in contact w/ ___

A

extend to limits of pleural cavities even during maximum inspiration

parietal, don’t coincide

parietal, each other

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18
Q

major recesses

A

costodiaphragmatic recesses - at the sharp reflection of the costal pleura onto the diaphragmatic pleura

costomediastinal recesses - at the sharp anterior reflections of the costal pleura onto the mediastinal pleura

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19
Q

left costomediastinal recess

___ than the right recess due to the ___

the ___ enters this recess during ___

A

larger, cardiac notch of the left lung

lingula of the left lung, deep inspiration

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20
Q

mediastinum:

___ b/n the ___

divided into ___ by ___ which passes through the ___ & the ___

A

mobile midline septum, pleurae & lungs

superior & inferior mediastinum, an imaginary plane, sternal angle, lower border of the 4th thoracic vertebra

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21
Q

superior mediastinum:

lies ___

limited superiorly by the ___

situated chiefly behind the ___

posterior boundary is the ___

A

above the imaginary plane

superior thoracic aperture

manubrium sterni

first four thoracic vertebrae

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22
Q

inferior mediastinum:

lies below the ___

limited inferiorly by the ___

further subidived into ___

A

imaginary plane (sternal angle)

diaphragm

anterior mediastinum, middle mediastinum, & posterior mediastinum

23
Q

middle mediastinum

A

composed of pericardial sac & its contents

24
Q

anterior mediastinum

A

area between pericardial sac & sternum

25
Q

posterior mediastinum:

area between ___

situated behind ___ extending from the ___

A

vertebral bodies & pericardial sac

pericardial sac, 5th through 12th thoracic vertebrae

26
Q

main contents of superior mediastinum (anterior to posterior) (10)

A
thymus gland
brachiocephalic veins & superior vena cava
aortic arch & 3 branches
vagus & phrenic nerves
cardiac plexus of nerves
left recurrent laryngeal nerve (not the right)*
trachea
esophagus
thoracic duct
lymph nodes
27
Q

main contents of posterior mediastinum (7)

A
esophagus
esophageal plexus
thoracic aorta
thoracic sympathetic trunks (2 total)
thoracic splanchnic nerves
thoracic duct
azygous system of veins
28
Q

thymus gland (superior mediastinum):

lies immediately behind the ___ & may extend into the ___ & the ___

after puberty, it’s largely replaced by ___

A

manubrium sterni, base of the neck, anterior mediastinum

fat

29
Q

trachea & esophagus (superior mediastinum):

fill ___ aperture in ___ plane b/n ___

trachea lies ___ esophagus & bifurcates ___

above root of lung, trachea & esophagus are crossed by ___ on the right & the ___ on the left

A

superior thoracic, median, apices of lungs

in front of, behind the sternal angle

azygous vein, arch of the aorta

30
Q

carina (superior mediastinum):

cartilaginous ridge within the ___ that runs antero-posteriorly b/n the ___ at the site of the ___ at the lower end of the ___

this ridge lies to the ___ of the midline

A

trachea, two primary bronchi, tracheal bifurcation, trachea

left

31
Q

arch of aorta (superior mediastinum):

commences at the right border of the ___, runs upward, backward, & to the left in front of the ___

passes downward to the left of the ___ & ___ & ends at the ___

contains the ___ & the ___ in its concavity

A

sternal angle, trachea

trachea, esophagus, sternal angle

right pulmonary artery, left principal bronchus

32
Q

aortic knuckle (superior mediastinum)

A

left curve of the arch of the aorta creates this of posterior-anterior chest x-rays

33
Q

usual branches of the arch of the aorta (superior mediastinum) (3)

all three are crossed anteriorly by the ___

A

brachiocephalic trunk

left common carotid artery

left subclavian artery

left brachiocephalic vein

34
Q

brachiocephalic trunk (superior mediastinum):

passes upward & to the right of the ___ & divides into the ___ & ___ behind the ___ joint

A

trachea, right subclavian, right common carotid arteries, right sternoclavicular

35
Q

left common carotid artery (superior mediastinum):

passes upward to the left of the ___ & enters the ___ behind the ___

A

trachea, neck, left sternoclavicular joint

36
Q

left subclavian artery (superior mediastinum):

arises behind the ___

A

left common carotid

37
Q

coarctation of the aorta:

aortic arch is abnormally ___ just beyond the ___ branch

for blood to reach that part of the aorta beyond the constriction, it must flow from branches arising ___ the constriction and follow ___ channels to reach branches arising ___ the constriction

the ___ arteries & the ___ channels become greatly ___ to accommodate the demands of the increased blood flow

a pulse can be found in the ___ spaces

the dilated ___ arteries press on the ___ border of the ribs causing localized areas of ___

these can be seen in x-ray films as ___ of the ___ border of the ribs

A

narrow/constricted, left subclavian

before, anastomotic, beyond

intercostal, anastomotic, dilated

intercostal

intercostal, inferior, resorption

notching, inferior

38
Q

brachiocephalic veins (superior mediastinum):

right & left brachiocephalic veins are formed by the union of the ___ & ___ behind the ___

the left brachiocephalic vein passes obliquely downward & to the right & unites w/ the ___ to form the ___ behind the ___

A

subclavian, internal jugular veins, right & left sternoclavicular joints

right brachiocephalic vein, superior vena cava, sternal end of the first costal cartilage

39
Q

superior vena cava (superior mediastinum):

descends & enters the ___ behind the ___

receives the ___ just before entering

A

right atrium of the heart, third right costal cartilage

azygous vein

40
Q

vagus nerves (superior mediastinum):

at the root of the neck, both right & left vagus nerves lie b/n the ___ & the ___

both descend in front of the ___

both descend in the ___ behind the ___

A

internal jugular vein, common carotid arteries

first part of the subclavian arteries

thorax, roots of the lungs

41
Q

recurrent laryngeal nerves (superior mediastinum):

arise from each of the ___ & ascend to supply the ___

A

vagus nerves, larynx

42
Q

left recurrent laryngeal nerve* (superior mediastinum):

hooks around the ___ behind the ___

ascends in a groove b/n the ___ & ___

A

left side of the arch of the aorta, ligamentum arteriosum

trachea, esophagus

43
Q

right recurrent laryngeal nerve* (superior mediastinum):

hooks around the ___ in the root of the ___

not found in the ___

A

right subclavian artery, neck

mediastinum

44
Q

phrenic nerves (superior mediastinum)

formed from the ___

both nerves enter the superior mediastinum b/n the ___ & ___ & lateral to the ___

both nerves descend ___ of the roots of the lungs*

A

ventral rami of C3, C4, & C5

subclavian artery, vein, vagus nerves

in front of

45
Q

innervation of phrenic nerves (superior mediastinum):

somatic efferent (___) (1)

somatic afferent (___, ___) (5)

A

(motor)
- diaphragm

(sensory, pain sensation):*

  • fibrous pericardium
  • parietal serous pericardium
  • mediastinal parietal pleura
  • central part of the diaphragmatic parietal pleura
  • central part of the diaphragmatic parietal peritoneum
46
Q

esophagus (posterior mediastinum):

begins as a continuation of the ___ at the level of ___

enters the superior mediastinum b/n the ___ & the ___ & behind the ___

enters the posterior mediastinum to the right of the ___ & behind the ___ & ___

deviates to the left crossing in front of the ___ just before it passes through the diaphragm at the level of ___*

A

pharynx, C6

trachea, vertebral column, left principal bronchus

aorta, pericardium, left atrium

aorta, T10*

47
Q

esophageal constrictions (superior to inferior) (posterior mediastinum):

where the ___ joins the upper end

where it contacts the ___

where it contacts the ___

the ___ of the diaphragm

A

pharynx

arch of the aorta

left principal bronchus

esophageal hiatus

48
Q

esophageal plexus (posterior mediastinum):

as the vagus nerves reach the esophagus, each nerve ___ & there is an interchange of ___ b/n the nerves forming the esophageal plexus

a little above the diaphragm, the plexus usually gives rise to two ___

the one on the left turns forward & is referred to as the ___

the one on the right turns backward & is referred to as the ___

A

breaks up into several trunks, branches

two nerve trunks

anterior vagal trunk

posterior vagal trunk

49
Q

descending throacic aorta (posterior mediastinum):

begins as a continuation of the ___ at the left side of the ___

it descends downward at first on the left side of the ___ & then gradually approaches the ___

it passes through the ___ of the diaphragm at the level of ___

A

arch of the aorta, sternal angle

vertebral bodies, midline

aortic hiatus, T12

50
Q

thoracic branches (posterior mediastinum) (5)

A
lower nine posterior intercostal arteries
subcostal arteries
bronchial arteries
esophageal arteries
superior phrenic arteries
51
Q

azygous venous system (posterior mediastinum)

primary purpose is to ___

system receives blood from ___

provides an alternative root for ___

A

drain blood from the body wall

some of the thoracic viscera

venous return from the lower parts of the body should the main venous channel be obstructed

52
Q

azygous venous system (posterior mediastinum):

vessels on two sides of body are ___

longitudinal channel on right is called the ___

on the left, the channel usually consists of two veins: the ___ & the ___

considerable ___ in azygous system

A

vessels on two sides of body are assymmetric

longitudinal channel on right is called the azygous vein

hemiazygous, accessory hemiazygous

variation

53
Q

azygous venous system: major tributaries (posterior mediastinum) (5)

A
most of posterior intercostal veins
bronchial veins
esophageal veins
pericardial veins
mediastinal veins
54
Q

thoracic duct (posterior mediastinum):

begins in ___ as a dilated sac called the ___

ascends through ___ & passes upward on right side of ___ b/n ___ & ___

at about the level of ___, begins crossing toward the left & reaches the left border of the ___ at level of ___

runs upward into the root of the ___ & empties into the venous system at the junction of the ___ & ___

A

abdomen, cysterna chyli

aortic hiatus, aorta, aorta, azygous vein

T5, esophagus, sternal angle

neck, left subclavian, left internal jugular veins